Dugald Blair Brown, a military surgeon and Fellow of the Royal College of Surgeons, Edinburgh, published twelve papers containing 77 case studies of gunshot wounds that he had treated in the Anglo-Zulu War of 1879 and in the First Anglo-Boer War of 1880–1881. Brown devised a “conservative” method of surgery, the early development of which had been influenced by Thomas Longmore (1816–1895), Joseph Lister (1827–1912), F. J. von Esmarch (1823–1912), and Carl von Reyher (1846–1890). During these conflicts, Brown reacted to surgical practices unsuited to the battlefield and not in the interest of the wounded. One such practice was “expectant” surgery, the practitioners of which dangerously substituted natural healing for immediate wound resection. Brown also criticized “operative” surgeons who, when faced with gunshot wounds of the extremities, expeditiously amputated limbs. Viewing each case as diagnostically unique, Brown tried to salvage limbs, to preserve function, and to accelerate recovery. To achieve these objectives, he used debridement, antisepsis, drainage, nutrition, and limited post-operative intervention.
Posterior Cloacal Variant with Clitorolabial Transposition and a Rectoperineal Fistula